Fellow Epilepsy Surgery Education: A Survey of U.S. Epilepsy Fellowship Program Directors
Abstract number :
2.299
Submission category :
9. Surgery / 9C. All Ages
Year :
2022
Submission ID :
2204391
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:24 AM
Authors :
Irfan Sheikh, MD – Massachusetts General Hospital, Harvard Medical School; Roohi Katyal, MD – University of Maryland Medical Center; Aris Hadjinicolaou, MD – Boston Children's Hospital; Camilo Gutierrez, MD – University of Maryland Medical Center; Brian Day, MD – Washington University School Of Medicine; Jay Gavvala, MD, MSCI – Baylor College Of Medicine; Saurabh Sinha, MD, PhD – Duke University Medical Center; Sandor Beniczky, MD – Danish Epilepsy Centre And Aarhus University; Fabio Nascimento, MD – Massachusetts General Hospital, Harvard Medical School
Rationale: To better understand the current state of epilepsy surgery education delivered to epilepsy fellowship trainees in the U.S.
Methods: An online survey focused on characteristics of epilepsy fellowship programs’ epilepsy surgery education was distributed to all 93 epilepsy fellowship program directors (adult and pediatric) listed on the ACGME website (accessed May 2022).
Results: Forty out of 93 (43%) program directors completed the survey. Training tracks offered by programs were adult epilepsy track only (45%), pediatric epilepsy track only (13%), and both adult and pediatric epilepsy tracks (42%). Number of epilepsy fellows currently undergoing training ranged from 1 to 3 in most epilepsy fellowship programs (73% adult track, 68% pediatric track). In most programs (55%), the mean number of epilepsy patients per year who underwent intracranial evaluation was >21. Further, in most programs, the mean number of neurostimulation cases was 1 to 10 for RNS (75%), 1 to 10 for VNS (45%), and 1 to 5 for DBS (50%).
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In the majority of programs (82%), fellows received dedicated training prior to presenting their first epilepsy surgery multidisciplinary conference. This varied significantly among programs and included didactics, surgical presentation-making workshops, review of prior case presentations, and direct feedback. In terms of fellow participation in epilepsy surgery multidisciplinary conference, in half of programs fellows were systematically invited to voice their recommendation during conferences, whereas in 15% of programs only the presenting fellow was invited to voice his/her management recommendations. Most programs (80%) reported not having any requirement as to a minimum number of epilepsy surgery cases presented by fellows prior to graduation. Half of programs (50%) reported utilizing objective measures to assess ACGME epilepsy surgery milestones. Presence of barriers to fellow epilepsy surgery education were reported by 23% of the programs. The most commonly reported barriers were low volume of surgical cases (33%) and COVID-related staffing issues (22%); possible solutions are summarized in Table 1.
Conclusions: Our results suggest significant variability in epilepsy surgery education for epilepsy fellows on a national level. Additionally, a large portion of fellowship programs do not utilize objective measures to assess epilepsy surgery competency. We believe that delineating nationwide fellowship epilepsy surgery education practices may be helpful to ensure that epilepsy fellows across the country undergo optimal training in this growing field within epilepsy.
Funding: None
Surgery